Chondroplasty of the knee is a surgical procedure designed to address damage within the joint’s articular cartilage. This intervention involves repairing or smoothing the cartilage surface to alleviate pain and improve joint function. The knee joint is a common site for cartilage degradation due to significant weight bearing and frequent use. Damage to this protective surface can severely limit mobility and cause chronic discomfort. The procedure aims to stabilize the joint surface, preventing further deterioration and potentially delaying the need for more extensive surgeries.
Understanding Knee Cartilage Damage
The ends of the bones within the knee are covered by articular cartilage, a smooth, resilient material. This cartilage acts as a shock absorber and provides a nearly frictionless surface, allowing the bones to glide smoothly during movement. Because articular cartilage does not possess its own blood supply, it has a very limited capacity to heal itself when damaged.
Damage to this tissue results from acute trauma, such as a sports injury, or from chronic mechanical wear and tear. As the cartilage surface breaks down, it develops rough, frayed edges or unstable flaps. These rough areas rub against the opposing joint surface, causing pain, inflammation, and symptoms like catching or locking within the joint.
How Chondroplasty is Performed
Chondroplasty is typically performed using an arthroscopic technique, a minimally invasive approach that utilizes small incisions. The surgeon makes a few tiny cuts, known as portals, around the knee joint. Through one portal, a narrow instrument called an arthroscope is inserted; this tool contains a small camera that projects magnified images onto a video monitor.
Sterile fluid is continuously pumped into the joint to expand the space and rinse away debris, providing a clear view of the joint interior. The surgeon inspects the articular surfaces, identifying areas of fraying or instability. Specialized surgical instruments, such as motorized shavers or burrs, are then inserted through the other portals.
The procedure focuses on debridement, where the unstable, rough, or damaged cartilage is carefully trimmed and smoothed. The surgeon removes loose flaps or fragments of tissue that cause mechanical irritation. The aim is to create a stable perimeter and achieve a smooth surface that will not generate friction during knee movement. Once smoothing is complete, the instruments are removed, the fluid is drained, and the small incisions are closed.
Immediate Recovery and Post-Operative Care
Following the procedure, patients often return home the same day because the surgery is minimally invasive. The immediate post-operative period, spanning the first few days to two weeks, focuses on managing pain and swelling. Pain medication is prescribed, and patients should use ice packs and elevate the leg frequently to minimize swelling.
Wound care for the small incisions is an important aspect of initial recovery. Dressings must be kept clean and dry for the first couple of days to prevent infection. Patients are typically allowed to shower within forty-eight hours, but soaking the knee is restricted until the incisions are fully healed. Depending on the extent of the smoothing, the surgeon may recommend using crutches for a short period to limit weight-bearing and protect the treated area.
Rehabilitation and Long-Term Expectations
Physical therapy (PT) is a cornerstone of rehabilitation following chondroplasty and should begin shortly after surgery. The initial phase of PT focuses on restoring a full range of motion without causing undue stress to the joint surface. Early exercises include gentle passive range of motion, where the leg is moved without using the surrounding muscles, and simple muscle activation exercises like quadriceps sets.
As healing progresses, rehabilitation shifts toward strengthening the muscles around the knee, including the quadriceps and hamstrings, to provide better joint support. Most patients can return to sedentary work or light daily activities within one to three weeks. However, returning to high-impact activities, such as running or sports involving cutting and pivoting, typically requires three to six months for full muscle strength recovery and joint stabilization. The long-term expectation is a reduction in mechanical symptoms like catching and locking, resulting in a more stable, functional joint.